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Exploring CBR workers’ perceptions of their role in wheelchair provision in three areas of Uganda

Seymour, Nikola (2016-03)

Thesis (MPhil (Rehabilitation))--Stellenbosch University, 2016.

Thesis

ENGLISH ABSTRACT:Background: Wheelchair provision and use in less resourced settings face significant challenges. Global efforts to affect change include the WHO Guidelines on provision of manual wheelchairs in less resourced settings and the WHO wheelchair training resources. Multiple stakeholders are required to collaborate to affect improvement, and in contexts where community-based rehabilitation (CBR) is implemented CBR workers have a role to play. Objectives: The objectives of the study were to determine what CBR workers in three areas of Uganda perceive as the challenges with wheelchair provision and use; the factors contributing to these challenges; the role they can play and what they need to achieve this.
Method: This qualitative, participatory study in the transformative paradigm gathered perceptions of twenty one CBR workers through three focus group discussions, in the north, west and central regions of Uganda.
Findings: Limited availability of appropriate products; financial constraints of people with disabilities (PWD) and wheelchair services; and historical and societal influences on beliefs are perceived by CBR workers to affect utilisation of wheelchair services and mobility of PWD. Participation is further influenced by inadequate skills in wheelchair use; limited durability of products and environmental factors including physical and attitudinal barriers. CBR workers suggested strategies which, if strengthened with training and closer partnership with wheelchair services, can positively impact the provision and use of wheelchairs in less-resourced settings. Findings also indicate the need to address issues related to the position and empowerment of CBR workers.
Conclusion: Contextual challenges to wheelchair provision and use in less-resourced settings would benefit from involvement of CBR workers. However, further efforts are required to increase the availability of appropriate wheelchairs and services, and to ensure the financial resources necessary to enhance effectiveness of both wheelchair services and community-based rehabilitation.

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